Comparison of the Effect of Glitazones and DPP-IV Inhibitors in Type 2 Diabetics as Add on Therapy on Insulin Sensitivity and Serum hs-CRP Levels.

To study & compare the effect of glitazones and DPP-IV inhibitors as add on therapy on Insulin sensitivity and serum hs-CRP levels in type 2 diabetes mellitus patients.Thirty patients (previously known cases of type 2 DM), aged above 18 years, were randomly included in the study. Group A, Glimepiride + Metformin + Pioglitazone (G + M + P) and Group B, Glimepiride + Metformin + Sitagliptin (G + M+ S). The study drugs were given on the basis of physician's discretion and the doses of study drugs were fixed according to their clinical presentation & followed up for a period of 3 months.The glycosylated haemoglobin (HbA1c) at the start of study (day 0) of group A was 10.39 ± 0.67 and in group B was 10.10 ± 0.62.The mean value of HbA1c at the end of the study period (day 90) in group A was 9.46 ± 0.61 and in group B was 9.04 ± 0.58. Insulin resistance at the start of the study (day 0) in group A, was 5.549 ±0.59 and in group B was 6.66 ± 0.76, The mean values of IR at the day 90, in group A was 3.42 ± 0.37 and in group B was 3.82 ± 0.61. The mean value of hs-CRP at the start of study (day 0) in group A was 4.34 ± 0.77 and in group B was 6.78 ± 1.18. The mean value of hs-CRP at the end of the study period (day 90) in group A was 2.8 ± 0.63 and in group B was 4.51 ± 0.73. There was no significant intra group or intergroup difference found in the above mentioned study paramaters .Both the study drug groups reduced HbA1c, insulin resistance, though there was no any significant difference. There was decrease in hs-CRP levels in both the groups. Moreover these combination therapies were safe and no serious adverse effects were reported.

Rosai Dorfman syndrome with extranodal manifestation.

Rosai Dorfman Syndrome (RDS) is a benign condition and a rare cause of cervical lymphadenopathy. It usually occurs in the first decade of life and manifest as massive enlargement of cervical lymph nodes. The disease has a benign course and involvement of the nasal cavity as an extranodal site is exceptional. A 22-year-old male presented as progressive massive bilateral cervical lymphadenopathy accompanied with nasal obstruction and occasional episodes of epistaxis. A FNAC from cervical lymph node and biopsy from nasal mass was compatible with RDS.